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How important is physical therapy after NA?
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12/07/2011 19:57
ademas 
12/07/2011 19:57
ademas 
How important is physical therapy after NA?

I had my second NA procedure done on Monday, and I just met with an occupational therapist who designed a splint for night use. She also gave me a few exercises to do.

She wants to see me 3 times a week for a few weeks, and honestly--beyond the night splint and the exercises she's already given me--I'm really not feeling the need.

I'd love to hear feedback from you folks re: your experience.

Thanks.

12/07/2011 20:22
callie 
12/07/2011 20:22
callie 
Re: How important is physical therapy after NA?

ademas,

My therapy was for surgery. I did almost exactly as you (exercises and night splint) for two sessions. I did the therapy on my own and my procedure turned out great (zero contracture after 10 years). My surgeon agreed with me that I could do the therapy on my own, but that I had to do it and not get lazy. It was no problem for me to do it during the day as part of my daily life. Perhaps it was better in that I did the exercises all during the day.

12/07/2011 22:23
flojo 
12/07/2011 22:23
flojo 
Re: How important is physical therapy after NA?

I had no PT after NA either time. Procedures were done 2 years apart. I did not have night splint after 1st NA but did get splint after NA done in July. The night splint seems to be helping.

Conceivably massaging my hand might have helped some, but I don't know that it would have made much difference either. For me, it was RT that made the most difference in that it stopped more nodules from developing.

12/08/2011 00:59
hammer 
12/08/2011 00:59
hammer 
Re: How important is physical therapy after NA?

I had xiaflex tratments on a cord that na could not release.Xiaflex released it.I had the injection on tuesday manipulation on weds and was back to work cutting meat on sunday.When I had surgery the stitches didnt come out for 2 weeks.My cords r to thick for na.Xiaflex is wicked stuff.Some people get bruising all the way to the elbow and armpit with it.But it works.Bigtime!!!

12/08/2011 02:14
flojo 
12/08/2011 02:14
flojo 
Re: How important is physical therapy after NA?

@Hammer

Glad it worked. It's good to hear about successful Xiaflex treatment. I understand that for some people it causes heavy bruising. If is effective and lasts a long time, it'll be worth it. Hope I don't but if I need cords released again in another 3 or so years, I will probably get Xiaflex.

Keep posting about it is going for you. It helps all of us.

12/08/2011 02:32
LubaM. 
12/08/2011 02:32
LubaM. 
Re: How important is physical therapy after NA?

I think physical therapy after NA, is very individual... as is everything related to DD and LD. What works for one person doesn't necessarily work for the next one. I wish there were more studies/statistics on everything related to this disease.

My case...I had NA in July 2006 for a badly bend PIP joint, small finger, right hand. Totally straight after the NA, wore a brace at night for about three months, had physical therapy twice a week for a few months, exercised on my own.... the contracture returned after about 6-9 months. Had a second NA on same finger in March 2010, for badly bend PIP joint. Again totally straight after NA, wore the brace a bit longer than three months, and again had phys. therapy.... the contracture returned after the exact same amount of time as the first time.

I believe some of us are just prone to quicker recurrence. I might try Xiaflex in the future for the small finger that had NA twice, but I am a bit scared to do it in view of the many people who have posted complications with Xiaflex such as bad bruising all the way to armpits, etc... and yet others have been very satisfied and have not had major complications...go figure...

My contracture on right hand small finger is the same now that it was before July 2006, not getting worst at least.

In the meantime I am watching carefully my other hand, where I had successful RT in Nov. 2009 that has put all the nodules in remission, for now.

12/08/2011 06:15
wach 

Administrator

12/08/2011 06:15
wach 

Administrator

Re: How important is physical therapy after NA?

Hi ademas,

once you understand what execises are useful then you can do them on your own. Seeing you 3 times a week after NA doesn't seem neccesary to me, except for billing purposes. It might be different after surgery where the hand is healing and its conditions changes over the weeks.

Wolfgang

ademas:
I had my second NA procedure done on Monday, and I just met with an occupational therapist who designed a splint for night use. She also gave me a few exercises to do.

She wants to see me 3 times a week for a few weeks, and honestly--beyond the night splint and the exercises she's already given me--I'm really not feeling the need.

I'd love to hear feedback from you folks re: your experience.

Thanks.

12/08/2011 06:26
wach 

Administrator

12/08/2011 06:26
wach 

Administrator

Re: How important is physical therapy after NA?

Hi LubaM,

that's very interesting that your recurrence is independent of how long you are wearing the splint. When you noticed the oset of recurrence, did you start wearing the night splint again?

The PIP joint of the small finger seems to be the most difficult joint to treat, irrespective of surgery, NA or Xiaflex. I myself had Xialfex injected last week for a PIP joint contracture of my right little finger. It was 45 deg before and is now 15 deg (but 10 deg is normal for me, my disease free little finger on the left hand has 10 deg). I am wondering how my finger will look a year from now.

Wolfgang

LubaM.:
I think physical therapy after NA, is very individual... as is everything related to DD and LD. What works for one person doesn't necessarily work for the next one. I wish there were more studies/statistics on everything related to this disease.

My case...I had NA in July 2006 for a badly bend PIP joint, small finger, right hand. Totally straight after the NA, wore a brace at night for about three months, had physical therapy twice a week for a few months, exercised on my own.... the contracture returned after about 6-9 months. Had a second NA on same finger in March 2010, for badly bend PIP joint. Again totally straight after NA, wore the brace a bit longer than three months, and again had phys. therapy.... the contracture returned after the exact same amount of time as the first time.

I believe some of us are just prone to quicker recurrence. I might try Xiaflex in the future for the small finger that had NA twice, but I am a bit scared to do it in view of the many people who have posted complications with Xiaflex such as bad bruising all the way to armpits, etc... and yet others have been very satisfied and have not had major complications...go figure...

My contracture on right hand small finger is the same now that it was before July 2006, not getting worst at least.

In the meantime I am watching carefully my other hand, where I had successful RT in Nov. 2009 that has put all the nodules in remission, for now.

12/08/2011 15:43
LubaM. 
12/08/2011 15:43
LubaM. 
Re: How important is physical therapy after NA?

wach:
Hi LubaM,

that's very interesting that your recurrence is independent of how long you are wearing the splint. When you noticed the oset of recurrence, did you start wearing the night splint again?

The PIP joint of the small finger seems to be the most difficult joint to treat, irrespective of surgery, NA or Xiaflex. I myself had Xialfex injected last week for a PIP joint contracture of my right little finger. It was 45 deg before and is now 15 deg (but 10 deg is normal for me, my disease free little finger on the left hand has 10 deg). I am wondering how my finger will look a year from now.

Wolfgang
LubaM.:

Hi Wolfgang,
I did wear the night splint at the beginning of onset of recurrence, but only for as long as it was comfortable to wear it, after a while the bending in the PIP joint made it too painful to wear... and the recurrence seemed to progress rather quickly once it started up.... I would say wear the splint as long as possible, just in case !

I am thinking that Xiaflex would be the way to go if I decide to treat that PIP joint again after two tries with NA. How was your experience with Xiaflex? any major side effects? Was this your first treatment for the PIP joint of that finger?

I am really scared because of the negative comments of "some" of the people here about their Xiaflex experience.

12/10/2011 12:09
wach 

Administrator

12/10/2011 12:09
wach 

Administrator

Re: How important is physical therapy after NA?

Side effects after my Xiaflex were not very severe. I had major swelling, pretty much like Bruce describes on http://www.dupuytren-online.info/dupuytr...xperiences.html. That picture with both hands could be mine as well. I also had hematoma in the little and ring finger and into the palm. It hurt but not dramatically. Today, 10 days after the injection, the swelling is neraly gone as are the hematoma.

I have the impression that my PIP joint wants to return to the contracted position and I am still wearing a splint 15 - 18 hours per day, with breaks in between to keep my joints flexible, and I am exercising flexion. I have no idea how long the current result will hold or whether it might even still improve a little bit over time. Future will tell.

My personal concern with Xiaflex is that, once injected, you can't stop it. If you missed the cord somewhat and the enzyme is leaking elsewhere you can't do anything about it. With NA when you are doing something wrong you just stop doing it. With Xiaflex you have to wait and see. But anyway, my PIP joint became fairly straight again and is now much better than before. That's what counts.

Wolfgang

Edited 12/11/11 08:44

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